EXPLANATION: CAPITALS INDICATE MATTER ADDE D TO EXISTING LAW .
[Brackets] indicate matter deleted from existing law.
Underlining indicates amendments to bill.
Strike out indicates matter stricken from the bill by amendment or deleted from the law by
amendment.
*hb1251*
HOUSE BILL 1251
J3, C4 5lr3170
By: Delegates Toles, Amprey, Atterbeary, Boafo, Boyce, Hill, D. Jones, J. Long,
Pasteur, Patterson, Smith, Taylor, Wells, White Holland, Wilkins, and
Williams
Introduced and read first time: February 7, 2025
Assigned to: Health and Government Operations
Committee Report: Favorable with amendments
House action: Adopted
Read second time: March 6, 2025
CHAPTER ______
AN ACT concerning 1
Health Care Facilities Hospitals and Medical Professional Liability Insurers – 2
Obstetric Services Policies 3
(Doula and Birth Policy Transparency Act) 4
FOR the purpose of requiring certain health care facilities hospitals to adopt and provide 5
evidence to the Maryland Department of Health that the health care facility hospital 6
has a certain policy certain policies relating to obstetric services; requiring the 7
Maryland Department of Health to provide certain policies to the public on request; 8
requiring insurers that issue or deliver medical professional liability insurance 9
policies in the State, on request, to provide the Maryland Department of Health with 10
information regarding the insurer’s policy regarding coverage of obstetric services; 11
and generally relating to obstetric services. 12
BY adding to 13
Article – Health – General 14
Section 19–2601 and 19–2602 to be under the new subtitle “Subtitle 26. Health Care 15
Facility Hospital Obstetric Services Policy” 16
Annotated Code of Maryland 17
(2023 Replacement Volume and 2024 Supplement) 18
BY adding to 19
Article – Insurance 20
Section 19–104.1 21 2 HOUSE BILL 1251
Annotated Code of Maryland 1
(2017 Replacement Volume and 2024 Supplement) 2
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 3
That the Laws of Maryland read as follows: 4
Article – Health – General 5
SUBTITLE 26. HEALTH CARE FACILITY HOSPITAL OBSTETRIC SERVICES POLICY. 6
19–2601. 7
(A) IN THIS SUBTITLE THE FOLLOWING WORDS HAVE THE MEANINGS 8
INDICATED. 9
(B) “FREESTANDING AMBULATO RY CARE FACILITY ” HAS THE MEANING 10
STATED IN § 19–3B–01 OF THIS TITLE. 11
(C) “HEALTH CARE FACILITY ” MEANS A HOSPITAL OR FREESTANDING 12
AMBULATORY CARE FACI LITY THAT PROVIDES O BSTETRIC CARE . 13
(D) “HOSPITAL” HAS THE MEANING STAT ED IN § 19–301 OF THIS TITLE. 14
(B) “DOULA” MEANS A NONMEDICAL P ROFESSIONAL WHO PROV IDES 15
CONTINUOUS PHYSICAL , EMOTIONAL, AND INFORMATIONAL SU PPORT TO THE 16
BIRTHING PARENT THRO UGHOUT THE PRENATAL , LABOR, AND POSTPARTUM 17
PERIODS. 18
(C) “HOSPITAL” MEANS A HOSPITAL , AS DEFINED IN § 19–301 OF THIS 19
TITLE, THAT PROVIDES OBSTET RIC CARE. 20
(D) “SIGNIFICANT MEDICAL I NTERVENTION ” MEANS A CESAREAN SEC TION, 21
INDUCTION OF LABOR , AUGMENTATION OF LABO R, OPERATIVE VAGINAL DE LIVERY, 22
OR EPISIOTOMY . 23
19–2602. 24
(A) A HEALTH CARE FACILITY HOSPITAL SHALL ADOPT AND PROV IDE 25
EVIDENCE TO THE DEPARTMENT THAT THE HEALTH CARE FACILITY HOSPITAL HAS 26
A POLICY THAT: 27
(1) A DOULA POLICY THAT AL LOWS EVERY BIRTHING PARENT TO 28
HAVE AT LEAST ONE DO ULA PRESENT DURING B IRTH IN ADDITION TO AUTHORIZED 29
GUESTS; 30
HOUSE BILL 1251 3
(2) AN INFORMED CONSENT POL ICY FOR SIGNIFICANT MEDICAL 1
INTERVENTION FOR THE BIRTHING PARENT ; AND 2
(3) A TRANSFER ACCEPTANCE POLICY THAT INCLUDES THE 3
HOSPITAL’S PROCESS FOR RECEIV ING: 4
(I) A PATIENT FROM A HEALT H CARE PRACTITIONER 5
REGULATED UNDER TITLE 8 OF THE HEALTH OCCUPATIONS ARTICLE WHO HAD 6
PROVIDED SERVICES TO A BIRTHING PARENT IN A HOME BIRTH SETTING ; 7
(II) A BIRTHING PARENT ’S OR NEWBORN ’S MEDICAL 8
INFORMATION FROM THE HOME BIRTH PROVIDER ; AND 9
(III) A TRANSFER FROM A LICE NSED DIRECT–ENTRY MIDWIFE 10
THAT IS CONSISTENT W ITH THE REQUIREMENTS OF § 8–6C–08 OF THE HEALTH 11
OCCUPATIONS ARTICLE. 12
(1) ALLOWS EVERY BIRTHING PARENT TO HAVE A CER TIFIED DOULA, 13
AS DEFINED IN § 15–141.4 OF THIS ARTICLE, PRESENT DURING BIRTH , IN ADDITION 14
TO ANY AUTHORIZED GU ESTS; 15
(2) PRIORITIZES NEWBORN B ONDING WITH THE FAMI LY OF THE 16
NEWBORN; 17
(3) PROHIBITS THE HEALTH CARE FACILITY FROM U SING 18
SIGNIFICANT MEDICAL INTERVENTION IN THE BIRTHING PROCESS WIT HOUT THE 19
INFORMED CONSENT OF THE BIRTHING PARENT , INCLUDING: 20
(I) THE ADM INISTRATION OF A MED ICATION THAT WILL 21
INDUCE LABOR ; 22
(II) A CESAREAN SECTION ; AND 23
(III) USE OF FORCEPS; 24
(4) DETAILS THE HEALTH CA RE FACILITY’S PROCESS FOR RECEIV ING 25
A BIRTHING PARENT ’S MEDICAL INFORMATIO N FROM A HEALTH CARE PROVIDER 26
REGULATED UND ER TITLE 8 OF THE HEALTH OCCUPATIONS ARTICLE WHO HAS 27
PROVIDED SERVICES TO THE BIRTHING PERSON ; AND 28
(5) ESTABLISHES A PROCESS TO TRANSFER AND RECE IVE PREGNANT 29
PERSONS ACROSS THE H EALTH CARE FACILITY ’S LEVELS OF CARE WIT HIN THE 30
FACILITY’S CAPACITY AND CAPABILITY. 31
4 HOUSE BILL 1251
(B) THE PROCESS DETAILED IN THE POLICY REQUIR ED UNDER SUBSECTION 1
(A)(4) OF THIS SECTION SHAL L INCLUDE A PROCESS FOR TRANSFERRING MED ICAL 2
RECORDS WHEN THE BIR THING PARENT WAS REC EIVING SERVICES FROM THE 3
HEALTH CARE PROVIDER IN A HOME BIRTH SET TING. 4
(C) (B) A HEALTH CARE FACILITY HOSPITAL SHALL PROVIDE EVIDEN CE 5
TO THE DEPARTMENT THAT THE HEALTH CARE FACILITY HOSPITAL HAS ADOPTED 6
A POLICY UNDER SUBSE CTION (A) OF THIS SECTION: 7
(1) (I) ON OR BEFORE JANUARY 1, 2026; OR 8
(II) IF THE HEALTH CARE FACILITY HOSPITAL IS ESTABLISHED 9
AFTER JANUARY 1, 2026, ON THE ESTABLISHMENT OF THE HEALTH CARE FACILITY 10
HOSPITAL; AND 11
(2) WHENEVER THE POLICY I S UPDATED. 12
(D) (C) THE DEPARTMENT SHALL ADOP T REGULATIONS TO CAR RY OUT 13
THIS SECTION, INCLUDING REGULAT IONS THAT ESTABLISH THE FORM AND MANNER 14
IN WHICH A HEALTH CARE FACILITY HOSPITAL MAY PROVE TO THE DEPARTMENT 15
THAT THE HEALTH CARE FACILITY HOSPITAL HAS ADOPTED A POLICY IN 16
COMPLIANCE WITH THIS SECTION. 17
(D) THE DEPARTMENT SHALL MAKE THE POLICIES PROVIDE D BY A 18
HOSPITAL UNDER THIS SECTION AVAILABLE TO THE PUBLIC ON REQUES T AND IN A 19
MANNER DETERMINED BY THE DEPARTMENT . 20
(E) THIS SECTION DOES NOT PROHIBIT A HOSPITAL FROM SETTING A 21
POLICY THAT RESTRICT S THE NUMBER OF DOUL AS OR AUTHORIZED GUE STS. 22
Article – Insurance 23
19–104.1. 24
ON REQUEST , AN INSURER THAT ISSU ES OR DELIVERS MEDIC AL 25
PROFESSIONAL LIABILI TY INSURANCE POLICIE S IN THE STATE SHALL PROVIDE T HE 26
MARYLAND DEPARTMENT OF HEALTH WITH INFORMATI ON REGARDING THE 27
INSURER’S POLICY RELATED TO COVERAGE OF OBSTET RIC SERVICES, INCLUDING 28
COVERAGE FOR A VAGIN AL BIRTH AFTER CESAR EAN. 29
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 30
October 1, 2025. 31